Lecture content on hypertension prevention and health care knowledge

More than 90% of essential hypertension can be prevented and controlled in advance through two core actions: lifestyle adjustment and regular blood pressure monitoring. Even high-risk groups with a family history of hypertension can delay the onset of the disease by 10 to 15 years, and many people may even avoid the disease throughout their lives.

Last week I met a 32-year-old programmer at a community free clinic. His blood pressure was 148/95 during a physical test. His face turned pale when he took the report. He said that his father was only diagnosed with high blood pressure when he was 50 years old. How come he stepped on the line almost 20 years in advance? After careful questioning, I found out that he stayed up until two or three o'clock every day to change the code, drank three cans of iced Coke a day, added double portions of salty sauce to every takeout, and stayed at home for two days on weekends without even going downstairs. With this kind of living habit, even if there is no family history, sooner or later he will have high blood pressure.

Let me first tell you about the food issue that concerns you the most. When many people hear that they need to prevent high blood pressure, their first reaction is to give up salt. In fact, academic circles have different opinions on this matter. The mainstream low-sodium and high-potassium school of thought recommends that adults consume no more than 5g of salt per day, which is roughly the amount of a beer bottle cap with the rubber pad removed. If you usually like to nibble on soy sauce duck, eat instant noodles, and drink salty milk tea, this part of invisible salt will be deducted from the total share. But there is another school of research that believes that as long as you don’t have high blood pressure, and you don’t eat pickles or soy sauce all the time, it’s perfectly fine to eat iodized salt normally. However, deliberately limiting sodium may lead to electrolyte imbalance and make you feel sluggish. Both statements are supported by clinical data. The core is to look at your own risk level: if there are more than three patients with hypertension in your immediate family, and your own BMI exceeds 24 and you have a big belly, then you should rely on the 5g standard. ； If no one in the family has high blood pressure and they like to be active, there is no need to worry about missing half a spoonful of salt.

Oh, by the way, don’t believe the nonsense about “drinking red wine softens blood vessels and prevents high blood pressure.” A large sample study published by The Lancet last year has made it clear that as long as alcohol is consumed, it will cause damage to the endothelium of blood vessels. There is no so-called “safe amount” of even one sip. If you really can’t refuse the drink, eat more high-potassium foods such as bananas, spinach, and mushrooms the next day after drinking, which can slightly promote sodium excretion, but it is best to push it as long as you can. In the past three years of my career in chronic disease management, I have seen a 42-year-old business executive. Taking advantage of his youth, he even drank liquor with a client after being diagnosed with borderline high blood pressure. Last winter, he suffered a cerebral hemorrhage and was sent to the emergency room. Now he still has to use crutches to walk. I also met 62-year-old Uncle Zhang, whose parents both had high blood pressure. When he was 50 years old, his blood pressure was found to be at the critical value of 135/85. He quit smoking after 30 years of smoking that same day. He took his wife for a 40-minute walk around the community after dinner every day. Now he is 70, his blood pressure has been stable at 120/80, and he has not even taken antihypertensive drugs.

Many people ask whether it is necessary to run 3 kilometers and swim for half an hour every day to prevent high blood pressure? There is no standard answer to this either. An old professor who studies geriatric diseases argued with me for half an hour before, saying that people should rest when they get old, and moving too much will damage the joints. In fact, there is really no need to engage in either/or. If you like to move, jogging, Tai Chi, or swimming three times a week is fine. ； If you are naturally inactive, you can get water twice a day, go to the toilet twice more, get off the bus one stop before get off work and walk back, and exercise for a total of 30 minutes a day, and the effect will not be much different. The most taboo thing is to run 5 kilometers suddenly on a whim. You will be so exhausted that you will lie flat for the next half month, which may easily cause blood pressure fluctuations.

There is another point that is easily overlooked: emotions have a greater impact on blood pressure than you think. Last month, an aunt came to measure my blood pressure. Normally, the blood pressure test at home is fine. But when I was tutoring my grandson with homework, my blood pressure suddenly shot up to 150/95, and I also had a headache. This kind of long-term stress-induced hypertension will slowly turn into true hypertension. If you really encounter something that makes you angry, stop and take three deep breaths. If it doesn't work, let the other half of the family do it. You really don't have to ruin your body over tutoring homework or arguing over food.

Finally, let’s talk about monitoring. Don’t wait until you feel dizzy and have a headache before you think of measuring your blood pressure. Just have an upper-arm electronic blood pressure monitor at home. Don’t buy the wrist-type ones, as most of them are inaccurate. You don’t need to take a test every day. Take it two or three days a week. Take the test twice in the morning after going to the toilet or when you haven’t eaten or drank. Take an average of 1 minute and write it down. It’s much more accurate than going to the hospital once every six months. After all, many people get nervous when they see people wearing white coats. The measured blood pressure is falsely high. That’s called “white coat hypertension” and it doesn’t count.

What I’m talking about today is not to tell you to live cautiously, not daring to eat or drink anything, but to have an idea in your mind and pay a little attention, which is better than waiting for high blood pressure and taking medicine for a lifetime, and having to worry about the complications of cerebral infarction and cerebral hemorrhage. If you still have any questions, just stay after the meeting and I will take your blood pressure one-on-one and adjust your daily habits based on your situation.